Cephalohematoma

A cephalohematoma is a collection of blood under the scalp of a newborn infant. The blood is located between the baby's bones of the skull and the lining over the bones (the periosteum). This is usually an injury that occurs during the birthing process of labor and delivery. There may be no evidence of trauma during labor or delivery. These injuries may happen more commonly in first pregnancies, if the baby's head is larger than the birth canal as with a large baby. Sometimes the injury occurs with forceps or vacuum extraction use. Forceps are a tool that helps in delivering a baby. That may be because forceps are used in more difficult deliveries. Forceps usually protect the baby's head during delivery because they do not allow the head to be squeezed as hard. Sometimes a fracture (break) of one of the bones in the skull is the cause. Such fractures usually occur on the sides of the head.

DIAGNOSIS

The diagnosis is usually made by your caregiver by X-ray of the baby's head. It is based on where the blood is located and if it is present over one of the skulls bones. The blood follows the outlines of one of the bones of the skull without extending past the outline of that skull bone.

TREATMENT

Most cephalohematomas get better with no treatment within 3 months. Even when fairly large they usually are not drained with a needle because this increases the chance of starting an infection.

RELATED COMPLICATIONS

  • If the collection of blood is large it may take a long time to get better. This is usually not a problem.

  • If so much blood is trapped that there is less in the baby's vessels, there may be lower amounts of red blood cells (anemia). Sometimes a blood transfusion may be necessary.

  • Also when blood breaks down, it makes the bilirubin rise and the baby may become jaundiced. This may require phototherapy in unusual cases.

  • Sometimes calcium deposits may form in blood left behind. Although it may seem unsightly, it also will usually leave with time.

  • These small fractures usually do not need treatment.

Caput Succedaneum is a similar condition except the swelling is fluid, not blood. This fluid collection is located closer to the surface and is not limited to a location right over a skull bone. It usually disappears in a couple of days. Discuss with your caregiver if there is any bulge over the baby's skull, and ask your caregiver if there is a possibility of anemia or jaundice.